Long-Term Exposure to TNFi Therapy May Not Affect Fertility in Men With Spondyloarthritis

Pregnant woman and her husband at consultation with male nurse in doctors office.

Pregnancy and offspring outcomes were reassuring in couples where men with spondyloarthritis (SpA) were exposed to tumor necrosis factor inhibitors (TNFi), according to results from a study published in The Journal of Rheumatology.

Researchers conducted a multicenter prospective study of 202 men with SpA who were exposed to TNFi therapy for a minimum of 12 months. The team assessed several parameters, including patient demographics, disease-related factors, and pregnancy outcomes in both female partners and offspring. These outcomes were compared with outcomes data from the general population and statistical analysis was performed.

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After analysis, the researchers found that 33 pregnancies were achieved in 27 men with ankylosing spondylitis who were exposed to continuous, long-term monotherapy with TNFi. Among these pregnancies, 30 healthy children were fathered and 3 elective abortions were performed for personal reasons.

In addition, no cases of congenital malformation or pathology, preeclampsia or eclampsia, stillbirths, or spontaneous abortions were reported.

The researchers noted that one key limitation of the study was the small sample size.

“The prospective analysis of the pregnancy and offspring outcome in patients exposed to long term therapy including the pre-conception period is reassuring regarding reproduction capacity and the health status of the offspring,” the researchers wrote.

“Larger prospective, controlled studies are needed in order to confirm these findings,” they concluded.


Micu MC, Ostensen M, Bojinca V, et al. Pregnancy outcome in couples with males exposed to long term anti – TNF alpha blocker therapies – a prospective study [published online March 1, 2019]. J Rheumatol. doi:10.3899/jrheum.180588